Милдронат®

General characteristics. Structure:

Active ingredients: 1 capsule contains 250 mg 3-(2,2,2-trimetilgidraziniya) of propionate of a dihydrate. 
Excipients: potato starch, silicon dioxide colloid, calcium stearate. Firm dosage forms. Capsules.

Active ingredients: 1 ml of injection solution contains 100 mg 3-(2,2,2-trimetilgidraziniya) of propionate of a dihydrate. Excipient: water for injections.

Pharmacological properties:

Mildronate – a structural analog of a gamma butyrobetaine, the predecessor of a carnitine. Drug, oppressing activity scale – butyrobetainehydroxylases, reduces biosynthesis of a carnitine and transport of dlinnotsepochny fatty acids through membranes of cells, preventing accumulation in cells of active forms of unoxidized fatty acids – predecessors of an acylcarnitine And, thus preventing their adverse action.
Mildronate recovers balance of processes of delivery of oxygen and its consumption in cells, prevents disturbance of transport of ATP, along with it activates glycolysis that occurs without additional consumption of oxygen.
As a result of decrease in concentration of a carnitine synthesis scale – a butyrobetaine in which vasodilating properties are inherent increases.
The mechanism of effect of Mildronate defines a wide range of its pharmacological effects. It increases working capacity, reduces symptoms of a physical and mental overstrain. 
Drug has the expressed cardiotyre-tread action. At heart failure it improves sokratitelny ability of a myocardium, increases tolerance to an exercise stress. At stable stenocardia ІІ, ІІІ a functional class increases physical working ability of patients and reduces the frequency of attacks of stenocardia.
At acute and chronic disorders of cerebral circulation Mildronate improves blood circulation in the ischemia center, promotes redistribution of a brain blood-groove in favor of the ischemic site. 
Also tonic action on TsNS is inherent in Mildronate, it eliminates functional disturbances somatic and the autonomic nervous system, including at an abstinence syndrome at patients with an alcoholism. Drug also has positive effect on dystrophic the changed vessels of a retina and on cellular immunity.

Indications to use:

- in complex therapy of coronary heart disease (stenocardia, a myocardial infarction), chronic heart failure and a dishormonal cardiomyopathy, 
- in complex therapy of acute and chronic disorders of blood supply of a brain (brain strokes and cerebrovascular insufficiency). 
- hemophthalmia and retinal apoplexies of various etiology, fibrinferments of the central vein of a retina and its branches, retinopathies of various etiology (diabetic, hypertensive). 
- reduced working capacity; a physical overstrain, including at athletes. An abstinence syndrome at an alcoholism (in a combination with specific therapy of alcoholism).

Route of administration and doses:

1. Cardiovascular diseases. As a part of complex therapy on 0,5-1 g a day inside or intravenously (5-10 ml of solution for injections of 0,5 g / 5 ml), applying all dose at once or dividing it on 2 times. A course of treatment – 4-6 weeks. A cardialgia against the background of dishormonal dystrophy of a myocardium – inside, on 0,25 g 2 times a day. A course of treatment – 12 days.
2. Disturbance of cerebral circulation. An acute phase – on 0,5 g once a day intravenously within 10 days, passing to intake 0,5–1 g a day. General course of treatment of-4−6 weeks. 
Chronic disturbances – on 0,5 g inside in day. General course of treatment of-4-6 weeks. Repeated courses (usually 2−3 times a year) are possible after consultation with the doctor.
3. Vascular pathology and dystrophic diseases of a retina. Parabulbarno on 0,5 ml of solution for injections of 0,5 g / 5 ml within 10 days.
4. Intellectual and physical overworks, including at athletes. The adult on 0,25 g in 4 times a day or on 0,5 g intravenously once a day. A course of treatment – 10–14 days. If necessary treatment is repeated in 2 — 3 weeks. 
To athletes on 0,5–1 g in 2 times a day before trainings. Course duration during the preparatory period – 14–21 days, during competitions – 10–14 days.
5. Alcoholism. Inside on 0,5 g 4 times a day; intravenously – on 0,5 g 2 times a day. A course of treatment – 7 - 10 days.

Features of use:

Patients should be careful with chronic diseases of a liver and kidneys at prolonged use of drug. 
There are no sufficient data about use of Mildronate for children. 
Safety of use of drug during pregnancy is not proved. 
To avoid a possible adverse effect on a fruit, during pregnancy it is not appointed. 
It is not found out whether drug with mother's milk is emitted. If treatment by Mildronate is necessary for mother, then feeding of the child a breast is stopped.

Side effects:

In isolated cases – an itch, the dispeptic phenomena, tachycardia, excitement, changes of arterial pressure.

Interaction with other medicines:

Strengthens action of koronarodilatiruyushchy means, some hypotensive drugs, cardiac glycosides. It is possible to combine with anti-anginal means, anticoagulants, antiagregant, antiarrhytmic means, diuretics, bronchial spasmolytics. In view of possible development of moderate tachycardia and arterial hypotension, it is necessary to be careful at a combination with nitroglycerine, nifedipine, alpha adrenoblockers, antihypertensives and peripheral vazodilatator.

Contraindications:

Hypersensitivity to drug components, increase in intracranial pressure (at disturbances of venous outflow, intracranial tumors). Pregnancy, a lactation, children's age up to 12 years.

Overdose:

Sharp changes of arterial pressure towards hypotension are possible. Drug малотоксичен also does not cause side effects, patients hazardous to health.

Issue conditions:

According to the recipe

Packaging:

Capsules of 250 mg, on 10 capsules in the blister, on 4 blisters in cardboard packaging.

Capsules of 500 mg, on 10 capsules in the blister, on 6 blisters in cardboard packaging.

Solution for injections – on 5 ml solution in an ampoule, on 5 ampoules in planimetric packaging, on 2 planimetric packagings in a cardboard pack.